Pharmacy Analyst (Medicaid Business Unit - Remote)

Lensa; East Montpelier (VT); Remote; USD 57,000 - 108,000; Full time

Job summary

A leading healthcare company is seeking a Pharmacy Analyst to support the Medicaid/DSNP Business Unit. The role involves managing projects, analyzing data, and ensuring compliance with regulations. The ideal candidate will possess healthcare experience and strong analytical skills. This remote position offers a competitive salary and opportunities for professional growth.

Qualifications

• Healthcare experience required.
• Project Management experience required.
• Project Management certification preferred.

Responsibilities

• Manage projects, analyze data for process improvements.
• Develop new Pharmacy Medicaid/DSNP services.
• Ensure compliance with regulations and guidelines.

Skills

Critical Thinking

Problem-Solving

Communication

Advanced MS Office

Education

High school diploma / GED

Bachelor's Degree

Job description

Pharmacy Analyst (Medicaid Business Unit - Remote)

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Company:

Highmark Inc.

Job Description:

Job Summary

Work with the Pharmacy Medicaid/DSNP Business Unit's business owners, stakeholders, and management to achieve growth objectives. Organize and coordinate activities to focus on delivering results. Monitor progress, evaluate activities, and perform corrective actions as needed. Communicate regularly with customers regarding issues or concerns. Responsibilities include:

• Manage projects, analyze data for process improvements, and lead initiatives to meet business objectives.
• Develop new Pharmacy Medicaid/DSNP services or programs through research and feasibility analysis.
• Ensure compliance with regulations, policies, and guidelines, monitoring changes in legislation and industry trends.
• Provide analytic support, develop predictive models, and collaborate with stakeholders to translate insights into strategies.
• Translate business needs into requirements and specifications for applications and analyze change requests.

Essential Responsibilities

• Implement product/program designs, ensure quality, financial, and regulatory standards, and develop measurement methods for continuous improvement.
• Analyze data and business processes, support program oversight, and develop solutions to problems.
• Work with multidisciplinary teams and manage small to medium projects.
• Resolve escalated or complex issues and develop business and pharmacy benefit solutions.
• Communicate effectively across all levels of the organization and articulate problems and solutions.
• Research and develop competitive pharmacy benefit offerings to enhance member experience and product viability.
• Other duties as assigned.

Education:

• Required: High school diploma / GED
• Preferred: Bachelor's Degree

Experience:

• Required: Healthcare experience, Project Management experience
• Preferred: Project Management certification

Skills:

• Advanced MS Office skills, presentation experience, critical thinking, pattern recognition, problem-solving, excellent communication.

Additional Information:

Travel: 0-25%

Position Type: Office-based, occasional travel, some physical demands.

Pay Range: $57,700 - $107,800

Compliance: Adherence to legal, ethical, and privacy standards required.